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Should I be concerned with a PSA result of 0.014??

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Posted 10/1/2024 2:19 PM (GMT -5)
I just did my every 6 month PSA test and received the result this morning. After the Davinci prostatectomy in September 2011 and salvage radiation exactly 8 years ago and being undetectable all those 8 years, I get a PSA of 0.014 via the patient portal. No (<) symbol. Since my previous PSA test 6 months ago my health care network has gone through a complete change of facilites and the patient portal is totally different than the old one. I'm hoping that missing (<) is just an overlooked detail that needs to be corrected going forward.
I meet with my uro on Monday for my annual visit and hopefully he'll have the answer for me.
Posted 10/1/2024 3:42 PM (GMT -5)
Steve, let's hope it's a clerical error. If not, that's still darned low, and I'd suspect they would want another check in a few months to confirm--and given your history of IMRT, I'd also suspect they will want to see it get higher before they start doing scans to find whatever is happening.

I'd say it's cause for low level concern, not yet for worry. Let's see what they say, and hope in 3 or 6 months another check brings back the "<".
Posted 10/1/2024 3:49 PM (GMT -5)
Hey Hal,
That's pretty much what I'm thinking too. Thanks
Posted 10/1/2024 4:56 PM (GMT -5)
I wouldn't worry yet. It might just be a glitch. The important thing is to continue watching it to see if it increase, and how fast it increases.

My situation is like yours. I had GS of 7 (3+4) and surgery 12 years ago. Three yeas later my PSA hit 0.02 because of a 1mm positive margin, so I had IMRT/IGRT (39 session for a total of 72 grays). The following 12 years (to date) my PSA has been 0.02. My oncology urologist said, "at this rate I will die from old age".
Posted 10/1/2024 5:34 PM (GMT -5)
Steve, before this last reading, when you were getting the "<", was it always <.014, or was it < some other number? If it was always <.014, then I think there's a good chance it was a mistake and they just left off the <. Fingers crossed. Worst case, nothing to do now except retest , maybe in 3 months.
Posted 10/1/2024 7:19 PM (GMT -5)
Hey Ken,

It was always <0.01......just 2 decimal places.
VIEW IMAGE

The image shows show the result is displayed on my patient portal now.
Posted 10/2/2024 5:58 AM (GMT -5)
Did you always go to labcorp?

Was this most recent test using the same “ROCHE ECLIA“methodology as the previous tests?


I would not bet on a missing sign but there is not anything you can do about it at such low levels except test again. So instead if waiting 6 months, do 3 months to minimize chances of missing big moves.
Posted 10/2/2024 8:35 AM (GMT -5)
Hi Stephen S,

Until the past year all of my testing was done at Tulane Hospital lab in New Orleans. In the past year they have merged with a couple of other facilities. As I mentioned earlier, The locations have changed and I have no idea if they used LabCorp previously or the Roche methodology.
Definitely not betting on the misplaced "<" symbol, but hoping that's the case.
Posted 10/2/2024 11:26 AM (GMT -5)
So all of these machines are not exactly the same. Just by virtue of the fact they spun it through a different machine might explain it.If they had used that machine for the past however many years it may have always read 0.014

Look at it again in 3 months. Try not to worry, which I know is easier said than done. That is the absolute limit of detectability. Your less than sign might reappear.

good for you, by the way, for keeping an eye out.
Posted 10/2/2024 12:54 PM (GMT -5)
I've never needed to learn about the various PSA analyzer devices because I've been undetectable for most of my journey. My results have always less than the limit of detectability and that's pretty much all that mattered to me. I'll see the uro on Monday and have him show me the actual reading and take it from there. Thanks for the input and I hope you have good luck with your case!
Posted 10/2/2024 5:02 PM (GMT -5)
Keep us posted Steve, fingers crossed for you
Posted 10/2/2024 8:08 PM (GMT -5)

Pratoman said...
Keep us posted Steve, fingers crossed for you

I sure will....thanks Ken.......Go Jets!
Posted 10/3/2024 2:50 PM (GMT -5)
Just imagine that your lab is one that gives out a score of <0.04 as undetectable. You wouldn't have to worry.
Best of luck going forward undetectable.
Posted 10/5/2024 9:35 AM (GMT -5)
It is all on the right side of the decimal point and with a zero first to boot. Sounds good to me. I've never had a PSA that low. Happy for ya.
Posted 10/6/2024 11:44 AM (GMT -5)
Thanks GoBucks and LargeBill68......I should get some clarification tomorrow (Monday) morning at my uro visit.
Posted 10/7/2024 11:02 AM (GMT -5)

NolaVette said...

Pratoman said...


hanks Ken.......Go Jets!

Bad timing LOLOL> I hate being a Jets fan
Posted 10/7/2024 4:55 PM (GMT -5)
I saw the doc this morning and the missing "<" symbol was not an oversight or clerical mistake. Although the reading is an extremely low PSA number, Dr. Morrison admitted the 0.014 result is technically not "undetectable". The plan is to do another PSA test in 3 months. Hopefully I'll be able to recover that all important less-than sign!
Posted 10/7/2024 6:46 PM (GMT -5)
Steve, Oh well, I guess it's now back to the waiting game, after all these years. Keep on keepin' on.
Posted 10/7/2024 7:36 PM (GMT -5)
0.014 is very very low.

Try to use the same lab each time, so it is an apples to apples comparison from last time.

After a while, assuming it is actually increasing, they will start calculating things like doubling time.

For now, its on the backburner, and its time to get back to *life*.
Posted 10/7/2024 7:52 PM (GMT -5)

Stephen S said...
0.014 is very very low.

Try to use the same lab each time, so it is an apples to apples comparison from last time.

After a while, assuming it is actually increasing, they will start calculating things like doubling time.

For now, its on the backburner, and its time to get back to *life*.

It'll defintely be the same lab for all future tests. Yes.....very low....right at the threshold of detectablility it appears, and that's after my previous PSA test on April 5, a full 6 months and that's as high as it got. As they say "It is what it is".
Posted 10/7/2024 11:51 PM (GMT -5)
If you use labcorp, you can ask for ultra sensitive with serial monitoring. I believe in that case they will use the same machine and keep its calibration consistent. I’m 13 years out and 3 weeks ago had a result of <.006. During my journey I have lost and regained the < symbol. There are fluctuations in all tests. And fwiw, Sloan Kettering only tests to .05, considering anything up to that clinically insignificant. Best of luck!
Posted 10/8/2024 8:23 AM (GMT -5)

FrackMe said...
If you use labcorp, you can ask for ultra sensitive with serial monitoring. I believe in that case they will use the same machine and keep its calibration consistent. I’m 13 years out and 3 weeks ago had a result of <.006. During my journey I have lost and regained the < symbol. There are fluctuations in all tests. And fwiw, Sloan Kettering only tests to .05, considering anything up to that clinically insignificant. Best of luck!

Thanks FrackMe....that's very good personal experience info to have. I'll check into the serial monitoring. Would that be something the uro/oncologist would need to request for me?
Posted 10/9/2024 3:54 PM (GMT -5)
NolaVette,
After your 13 years DX with PC, and the past 8 as undetectable, you should not worry about a 0.014 reading. I would go so far as to contradict your Doc and say the lab probably did forget the< sign. My City of Hope PSA tests recently instituted their newer ultra sensitive test down with their Lab test lower limits down to <0.008, but they previously were at the time, (2018-2022) at their Lab testing lower level for years at <0.014.

Straight math or MDK math makes it .014 over 4.5 (for average older man), so yours is 99.7 percent lower than average !! To put it another way , if you were average guy with no PC, your tiny PSA value may have dropped about 99.7 % with treatment . That is almost immeasurably low. Most of us would give our right nut to be there some day, I already did, due to Lupron! lol.

Stay strong, your ol PSA is going nowhere but the same value for many years to come, and no spread also.
Keep the Faith Brother.
Wings aka MDK in So Cal
Here is what Dr. "Bing Search says:
https://www.bing.com/chat?q=what+psa+is+technically+undetectable+for+someone+with+a+prostate&sendquery=1&form=hecodx
Posted 10/10/2024 6:47 AM (GMT -5)

Wings of Eagles said...
NolaVette,
After your 13 years DX with PC, and the past 8 as undetectable, you should not worry about a 0.014 reading. I would go so far as to contradict your Doc and say the lab probably did forget the< sign. My City of Hope PSA tests recently instituted their newer ultra sensitive test down with their Lab test lower limits down to <0.008, but they previously were at the time, (2018-2022) at their Lab testing lower level for years at <0.014.

Straight math or MDK math makes it .014 over 4.5 (for average older man), so yours is 99.7 percent lower than average !! To put it another way , if you were average guy with no PC, your tiny PSA value may have dropped about 99.7 % with treatment . That is almost immeasurably low. Most of us would give our right nut to be there some day, I already did, due to Lupron! lol.

Stay strong, your ol PSA is going nowhere but the same value for many years to come, and no spread also.
Keep the Faith Brother.
Wings aka MDK in So Cal
Here is what Dr. "Bing Search says:
https://www.bing.com/chat?q=what+psa+is+technically+undetectable+for+someone+with+a+prostate&sendquery=1&form=hecodx

Thanks much, Wings of Eagles for the encouraging post. The next test is scheduled for January 7th. Hoping for the best, but will deal with whatever it reveals.
Posted 10/15/2024 4:18 PM (GMT -5)
Maybe some one can comment on this, but is 7 years a common time frame post SRT for BCR?
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